This study helps to understand violent behavior but is not exhaustive on the phenomenon under investigation and requires a more in-depth analysis. The work has some limitations. Only the most recent literature of the last 10 years was considered and the PubMed and EMBASE databases were interrogated, not involving the minor ones. The sample of studies was oriented towards specific populations and this factor may have reduced the generalizability of the results. Learn about our crisis prevention intervention certification exam at our crisis prevention intervention certification exam page.



The aim of this survey was to evaluate the effectiveness of de-escalation techniques for the prevention and management of aggressive acts against healthcare personnel. Mental health workers react differently to violence. Some relate to patients in ways that produce positive solutions [21], while others manage patients with coercive measures. The effectiveness of the use of de-escalation techniques in the management of aggressive acts has emerged. However, it emerges that adequate staff training can guarantee more timely interventions and make nurses manage aggressive behavior. In fact, we note that de-escalationit is effective after knowing the patient, his pathologies and the signs that may indicate the onset of aggressive behavior, so that the techniques can be applied right from the start. There is a need to formulate hypotheses for qualitative improvement of risk situations and to update the professional skills of the nurse, through training courses in which to introduce patient management approaches. Furthermore, it could be interesting to investigate the rate of complaints and reports of health professionals to the judicial authorities, due to the violent attacks and the physical consequences. According to some studies, no complaints have been recorded [22,23] and this observation could suggest that the assault by a patient may be justified by a healthcare professional, 

This could lead to think that already during the escalation situation there is a passive predisposition of the nurse towards the patient. From the data in the literature, it appears that the attitudes of nurses are also an important element to be taken into consideration if we want to reduce episodes of violence. All this brings our attention to the concept of prevention, to offer training for health personnel on communication and management methods and to give psychological support and psychological preparation to increase awareness of one’s reactions and emotions in the face of the risk of violence. . Therefore, the operator could be made more prepared to foresee and manage dangerous situations, not only to “be able” but also to “feel able” to face them.